An instrument for use in the treatment of intracranial vascular disorders

ABSTRACT

An artery clamp useful in the treatment of intracranial aneurysms and other vascular disorders is provided by a clamp assembly including a clamp support plate, a yoke member having the limbs thereof in releasable engagement with the plate, a pressure plate mounted for reciprocation between and orthogonal to the limbs of the yoke member, a pressure plate reciprocating stem mounted in threaded engagement in the clamp support plate and in rotatable engagement at one end thereof with the pressure plate and shaped at the other end for engagement with a rotatable member of a control assembly and a control assembly including a tubular support member having a resilient end portion adapted for latching engagement with the clamp support plate, a rotatable pressure plate actuating member slidably and rotatably mounted in the tubular support member and having an end portion engageable with the outwardly projecting end portion of the pressure plate reciprocating stem of the clamp assembly for rotation thereof, a sleeve member slidably mounted on the tubular support member for urging the resilient end portion of the support member into latching engagement with the clamp support plate, disengageable lock means for preventing movement of the clamp lid actuating member in the tubular member, and disengageable lock means for preventing movement of the sleeve member on the tubular support member.

United States Patent William Gayle Crutchfield Department of Neurological Surgery School of Medicine University of Virginia, Charlottesville, Va. 22901 [21] Appl. No. 17,081

[22] Filed Mar. 6, 1970 [72] lnventor [45] Patented Jan. 4, 1972 [54] INSTRUMENT FOR USE IN THE TREATMENT OF INTRACRANIAL VASCULAR DISORDERS 2 Claims, 10 Drawing Figs.

[52] U.S. C 128/346,

128/326, 81/13, 145/52 [51] Int. Cl A6lb 17/12 [50] Field of Search 128/346,

OTHER REFERENCES Crutchfield, .lour. of Neurosurgery, Vol. 16, 4, 1959, pp. 471-474.

Primary ExaminerDalton L. Truluck AttorneyStowell & Stowell ABSTRACT: An artery clamp useful in the treatment of intracranial aneurysms and other vascular disorders is provided by a clamp assembly including a clamp support plate, a yoke member having the limbs thereof in releasable engagement with the plate, a pressure plate mounted for reciprocation between and orthogonal to the limbs of the yoke member, a pressure plate reciprocating stem mounted in threaded engagement in the clamp support plate and in rotatable engagement at one end thereof with the pressure plate and shaped at the other end for engagement with a rotatable member of a control assembly and a control assembly including a tubular support member having a resilient end portion adapted for latching engagement with the clamp support plate, a rotatable pressure plate actuating member slidably and rotatably mounted in the tubular support member and having an end portion engageable with the outwardly projecting end portion of the pressure plate reciprocating stem of the clamp assembly for rotation thereof, a sleeve member slidably mounted on the tubular support member for urging the resilient end portion of the support member into latching engagement with the clamp support plate, disengageable lock means for preventing movement of the clamp lid actuating member in the tubular member, and disengageable lock means for preventing movement of the sleeve member on the tubular support member.

PATENTEBJAN 41972 3531; 859

FIG. 2

INVENTOR WILLIAM GAYLE CRU TCHFIELD ATTORNEY 1 AN INSTRUMENT FOR USE IN THE TREATMENT OF INTRACRANIAL VASCULAR DISORDERS This invention relates to an improved form of artery clamp useful in the treatment of intracranial aneurysms and other vascular disorders.

In Journal of Neurosurgery, 1959, Vol. XVI, No. 4, pages 471-474, the applicant has described the construction and manner of use of an artery clamp embodying some of the features of the clamp described herein but presenting some disadvantages in use due to the absence of effective means for positively latching the control assembly to the clamp assembly and disengaging it therefrom without disturbing the setting of the clamp.

In its general aspect, the artery clamp of the invention comprises a clamp assembly including a clamp support plate, a yoke member having the limbs thereof in releasable engagement with the plate, a pressure plate mounted for reciprocation between and orthogonal to the limbs of the yoke member, a pressure plate reciprocating stem mounted in threaded engagement in the clamp support plate and in rotatable engagement at one end thereof with the pressure plate and shaped at the other end for engagement with a rotatable member of a control assembly and a control assembly including a tubular support member having a resilient end portion adapted for latching engagement with the clamp support plate, a rotatable pressure plate actuating member slidably and rotatably mounted in the tubular support member and having an end portion engageable with the outwardly projecting end portion of the pressure plate reciprocating stem of the clamp assembly for rotation thereof, a sleeve member slidably mounted on the tubular support member for urging the resilient end portion of the support member into latching engagement with the clamp support plate, disengageable lock means for preventing movement of the clamp lid actuating member in the tubular member, and disengageable lock means for preventing movement of the sleeve member on the tubular support member.

The principles of the invention will be more fully described with reference to the specific illustrative embodiment thereof shown in the accompanying drawing in which:

FIG. 1 is a perspective view of the artery clamp with clamp assembly and the control assembly in operative association;

FIG. 2 is a perspective view of the control assembly with a stabbing cap mounted thereon in place of the clamp assembly;

FIGS. 3 and 3a show the members of the clamp assembly in partial disconnection;

FIG. 4 shows the clamp assembly fully assembled;

FIG. 5 shows the clamp assembly with the end of the control assembly latched thereto;

FIG. 6 is a view of the control assembly in partial section;

FIG. 7 is an end view of the control assembly looking at the right end ofFIG. 6;

FIG. 8 is an end view of the control assembly looking at the left end of FIG. 6; and

FIG. 9 is a perspective view of the clamp of the invention in operative position in a patient.

As shown more particularly in FIGS. 3, 3a, 4 and 5, the clamp assembly comprises a support plate 10 having a detent member in the form of a rounded internally pierced and threaded boss 11 mounted on the outer face thereof. A V- shaped yoke member 12 has slots in the outer ends of the limbs thereof which snap into lugs on opposite edges of plate 10. Stem 13, threadedly mounted in boss 11, is in rotating engagement with clamp lid 14 and is actuated by a driver, hereinafter described, in the control assembly engageable with the slot outer end of the stem.

The control assembly, shown more particularly in FIGS. 1, 2, 6, 7 and 8 consists of a tubular member 15 having a slotted resilient end portion 15' for engagement with boss 11 of the clamp assembly. Rotatably and slidably mounted in member 15 is the shaft of screw driver 16 having a knurled handle 17 mounted on the outer end thereof. An eccentric mark such as dot 17 on handle 17 facilitates monitoring the position of lid 14 of the clamp assembly.

Slidably mounted on the tubular member 15 is tube 18 which, when slid to the right (as seen in FIG. 6), urges the resilient end portion 15 of tubular member 15 into latching engagement with detent ll of the clamp assembly.

Screw l9 permits locking screw driver 16 to member 15 and screw 20 permits locking tube 18 to member 15.

Handle 21, affixed to member 15, facilitates separation of the clamp assembly from the control assembly by pressing on handle 17 of screw driver 16.

Cap 22, shown in FIG. 2, positioned on the end of the control assembly in place of the clamp assembly facilitates insertion of the end of the control assembly into operating position in the incision adjacent the vessel to be clamped.

In using the artery clamp of the invention the yoke member 12 is placed around the artery exposed in a suitable incision 24 as shown in FIG. 9, and the ends of the yoke are snapped into the lugs on plate 10 with the artery between lid 14 and the base of the yoke. The end of the control assembly with cap 22 in position is then stabbed into the incision, the cap is removed, the end 15' of tubular member 15 is pushed into engagement with boss 11 and locked thereto by sliding tube 18 towards the clamp assembly. Tube 18 is then locked in position by screw 20. The clamp lid 14 is then suitably positioned by turning handle 17 of screw driver 16 and locked in position by screw 19. I

To remove the clamp, clamp lid 15 is retracted by turning screw driver 16, tube 18 is unlocked and retracted and the control assembly is pulled away from the clamp assembly by pulling on handle 21 while maintaining pressure on handle 17. The yoke member 12 is then removed from engagement with plate 10 with the aid of a hemostat or other forceps and the clamp assembly members are removed from the incision.

I claim:

1. An instrument for use in the treatment of intracranial aneurysms and other vascular disorders comprising,

a. a substantially U-shaped yoke member having a pair of parallel laterally spaced apart limbs connected at one of their adjoining ends and having opposing free ends,

b. a clamp support plate fitted between the free ends of the limbs of the yoke member,

c. releasable interengaging connecting means between said clamping support plate and the free ends of the limbs of the yoke member,

(I. a pressure plate mounted for reciprocation between and orthogonal to the limbs of the yoke member and disposed inwardly of the clamp support plate,

e. a pressure plate reciprocating stem mounted in threaded engagement in the clamp support plate and in rotatable engagement at one end thereof with the pressure plate and having an outwardly projecting end portion provided with engaging means,

f. a tubular support member having a resilient end portion in latching engagement with the clamp support plate,

g. a rotatable pressure plate actuating member slidably and rotatably mounted in the tubular support member and having an end portion provided with engaging means complementary to and engageable with the engaging means on the outwardly projecting end portion of the pressure plate reciprocating stem for rotation thereof,

h. a sleeve member slidably mounted on the tubular support member for urging the resilient end portion of the support member into latching engagement with the clamp support plate,

e. disengageable lock means for selectively preventing movement of the pressure plate actuating member in the tubular member, and,

j. disengageable lock means for selectively preventing movement of the sleeve member on the tubular support member.

2. The instrument of claim 1 wherein said clamp support plate carries an internally threaded externally rounded boss on the outer face thereof and the resilient end portion of the tubular support member is shaped to engage said boss. 

1. An instrument for use in the treatment of intracranial aneurysms and other vascular disorders comprising, a. a substantially U-shaped yoke member having a pair of parallel laterally spaced apart limbs connected at one of their adjoining ends and having opposing free ends, b. a clamp support plate fitted between the free ends of the limbs of the yoke member, c. releasable interengaging connecting means between said clamping support plate and the free ends of the limbs of the yoke member, d. a pressure plate mounted for reciprocation between and orthogonal to the limbs of the yoke member and disposed inwardly of the clamp support plate, e. a pressure plate reciprocating stem mounted in threaded engagement in the clamp support plate and in rotatable engagement at one end thereof with the pressure plate and having an outwardly projecting end portion provided with engaging means, f. a tubular support member having a resilient end portion in latching engagement with the clamp support plate, g. a rotatable pressure plate actuating member slidably and rotatably mounted in the tubular support member and having an end portion provided with engaging means complementary to and engageable with the engaging means on the outwardly projecting end portion of the pressure plate reciprocating stem for rotation thereof, h. a sleeve member slidably mounted on the tubular support member for urging the resilient end portion of the support member into latching engagement with the clamp support plate, i. disengageable lock means for selectively preventing movement of the pressure plate actuating member in the tubular member, and, j. disengageable lock means for selectively preventing movement of the sleeve member on the tubular support member.
 2. The instrument of claim 1 wherein said clamp support plate carries an internally threaded externally rounded boss on the outer face thereof and the resilient end portion of the tubular support member is shaped to engage said boss. 